Wherein a surgeon tells some stories, shares some thoughts, and occasionally shoots off his mouth. Like a surgeon.

Monday, November 12, 2007

No Alternative

The world seems to be losing its collective mind, so it shouldn't be surprising that even vaunted medical schools are making "alternative medicine" part of their curricula. Several bloggers have been and are doing a fine job of venting; I come late to the party. (For the record, it's my view that in swallowing the pill, these schools and other hospitals are in it for the marketing. Which is more cynical than the therapies they're touting.)

Many years ago I watched, drop-jawed, the television commercial of a local chiropractor as he stood by a couch-full of young kids. Recommending monthly preventative adjustments for these four- to six-year-olds, he touted the obvious benefits: look how healthy they are. Not, he seemed to imply, a heart attack among them. Nary a stroke. Probably not even a case of colon cancer. And I wondered: is he stupid enough to believe or is he simply a cynical and dishonest charlatan? I got a partial answer a few months later when a woman arrived in the emergency department, acutely paraplegic. Her chiropractor had continued manipulating her increasing and unresponsive back pain until she became paralyzed. The "doctor" must have known about her history of breast cancer, because he was also her husband.

Until that time, because the theory behind chiropractic is so obviously loony, I'd assumed practitioners all knew it and were simply crooks who'd found a surefire way to separate the credulous from their money. (And yes, I acknowledge that manipulation has a place in certain specific anatomic disorders of the back itself. But using it to treat or prevent systemic disease is nothing but laughable. Except that it's not funny.) Stupid, careless, lacking judgment: yes, the man must have been all that. But unless he hated his wife, I had to conclude he believed in what he was doing.

I still haven't figured it out, and I'm sure I never will. Of what do the cerebral lacunae consist in these people? How can (some) otherwise intelligent people (givers and takers) become convinced of the efficacy of whatever woo they wish? Is truth just too hard to take? At some primordial level, is it just that we need to believe in silly stuff? What is it about humankind that pines for magic, for simplicity, for answers that pave over the painful? Why isn't inquisitiveness universal; doesn't skepticism confer survival benefit? Or would we all be jumping off cliffs if we didn't have mythology? Maybe that's it. Maybe too many skeptics have already jumped.

The frailty, the neediness of the human brain, when stacked against the obvious power of it -- the ability to create, to invent, to inquire -- is a probative paradox. It may be a stretch to write my way from anger about alternatives and chafing at chiropractic, to the death of skeptics and skepticism, but in my mind it's of a piece. I have a friend, a brilliant physician and much more of a scientist than most, who tells me he knows, based on his particular faith, exactly into which level of heaven he will enter; as if he's already done a mapquest search and downloaded the directions. Given that there are about six billion people on the planet who believe something else, and with just as much certainty, I find it amazing. And revelatory. It's a need. It's built in. It's human.

My conclusion is that the desire to believe in certain unprovable things at one time was good for us: when the dangers in the world were mostly external -- volcanoes and saber-tooth tigers -- and the need to organize and stay together was clear, supernatural beliefs were of obvious benefit. And now, as society has gotten impossibly complex, and the dangers are mostly human-generated, it's become a detriment. Rather than helping mankind to cleave together and help one another, magical beliefs -- whether on couches or in the clouds -- are causing us to fall upon one another in hate, in fear, in the unreason that comes from a mind blown by the awful realities we have brought upon ourselves.

Magical thinking is who we are, I guess. If it were only that it serves to enrich some at the expense of others, maybe even make some people feel better, what the hell. If they're only hurting themselves, or the willingly deceived, should I let it go? But they are hurting people, and it's pretty clear that eventually it will hurt me. When I see this mainstreaming of stupid, I can't keep myself from thinking of the other side of the same coin: people flying into buildings, blaming hurricanes on gays, invading the wrong countries, laughing as we pee in the pool. The need for crazy-stupid is great; if straws they be, still grasp at them we must. We've gone from flivvers to Ferraris in a sigh and a gasp; from Kitty Hawk fields to the seas of the moon in the eye of a bat; Allan Pinkerton's shoes to spies in the skies: the power of scientific method is obvious to the most casual glance. Yet despite -- or is it because of -- the amazing progress we've seen at the hands of science in less than a lifetime, people willfully and seemingly in increasing numbers simply ignore it at their convenience. Need to ignore it. Demand to ignore it. Demand that I ignore it.

I don't think you should get to pick and choose. Don't believe in evolution? OK, then don't get on an airplane. Earth is twelve thousand years old? Fine. Take back your laptop. Homeopathy makes sense to you? No problem. Put down that cellphone, never avail yourself of GPS. Because if man and dinosaur occupied the same space and the same time, if carbon-dating is bogus, atomic clocks don't work and transplants are impossible. If vaccines cause autism, Rovers aren't on Mars and nothing will happen when I push the button to post this.

Wow, Sid. this is powerful! Thank you for such an articulate commentary that I may use (with appropriate credit given) to help explain why I have "lost my religion". When I was a child, my well intentioned parents took me to a chiropractor when I had horrific ear infections. It wasn't until my inner ear started bleeding that the chiropractor suggested they take me to an MD. The result was permanent (minor) hearing loss in my R ear.

Worse still are the granola people (future physicians, no less!) in today's med school classes who actually believe in this stuff, and get offended when the rest of us complain that it's a waste of our time.

i have mixed feelings about this post. as usual it is brilliantly constructed. i think you touching on mankind's desire to believe in magic (or whatever you want to call it) was spot on. it seems to be part of the human condition.

however, once identifying it as a human weakness, i do think one needs to give mankind leeway to believe their local brand of stupidity. i am not convinced that, for the average citizen one can hold them to the absolutes you propose in your final paragraph. i find most absolutes to be a bit too dogmatic. "you must believe in my brand of creationism or you will go to hell" and "if you don't believe in evolution then..." sound just too similar to me.

Dammit, Sid, how dare you post that picture of me while I'm dancing around the fire conjuring up the spirits. At least you caught me when I'm dressed. That's an avocado sandwich in the cauldron, by the way.

Sid, After reading your blog, I'm not enlightened. If it's not medicine, its hooey right? Didn't one of your evidence based colleagues state that only 15% of the medical treatments today have sound science justifying them? What is sad is that the medical profession grows more and more paranoid and frustrated that patients are becoming educated and asking more questions regarding the drugs their being prescribed and the side-effects that continue to be ignored. Is your frustration as an MD have anything to do with that you have drugs or surgery as the only answers to your patients diagnosis? Does it bother you that "alternative practitioners" get results with the patients that you can't help? How has the medical profession become so interested in bitching about CAM therapies. These therapies are being utilized more often today because medicine has failed these patients. Their sick of the pills and sadly you have nothing for them as a result. Maybe you should blog about how your profession needs to find a solution to the 186,000 people that die each year as a result of iatrogenic death.

having a neurological condition called Tourette Syndrome for 45 years and finding a forum and chatroom where i met people with many other disorders, i have read the gamut of things people will do to get relief from their pain and problems.

the last few years, i have seen a rise in the number of people turning to vitamins and supplements to relieve their problems. i think the internet has brought so much information and also misinformation to the masses.

i feel that most of the people who are trying alternative therapies are people who have had no success with traditional medicine and are looking for any therapy that will help them. some of these people are going to die from their diseases. some of them have diseases, like mine, for which there is no cure, just a relief of some symptoms. i have seen people post lists of medicines they are taking. it is unbelievable that they are going through all that and still not getting any relief.

so, i do not dismiss people who have said that untraditional therapies, like reiki or taking certain supplements, have helped them.

regarding religious or evolutionary or even political beliefs, i think people define their views from a smorgasbord of sources...from the region of the country they were raised, to the influences of their family, to the level of their education, to their innate intelligence, thus letting them exhibit incongruous beliefs.

so, i will continue to try the latest drug for my particular condition and if it helps more than hinders, i will be happy (so far, that hasn't happened, but i came darn close with abilify). but, when my neck tics are so bad and my head and muscles all ache for days, i will go and get an hour long massage and feel better faster and longer than taking flexeril.

jean: I'm sorry you have such a frustrating condition. Medicine is far from perfect, and falls far short of having all the answers. But it continues to seek them, and to test them. "Alternative medicine" is an oxymoron: if it's provable and works and is subject to review, it's medicine. If "alternative" works, it's medicine, not alternative. If it's not subject to testing and/or has been tested and failed, it's not "alternative," it's bogus. And whatever claims people make for therapies that work, ought to be testable and provable. Anonymous up there a couple of posts thinks the fact that medicine is as yet imperfect is an argument to abandon science and turn to woo. It's not. It's an argument to continue to inquire and to maintain rigorous standards. I hope answers get found for Tourette's. And for cancer. When they do, they will come from laboratories, not pulled out of someone's rear end. They'll be tested, and found to work. If it's snake oil that passes that test, I'll be as glad as anyone.

like "anonymous" I also have mixed feelings. I don't run to chiropractic when I have a general problem (right now, I use a steroid cream to treat a particularly tenacious case of exzema on my hands) I know its better to fix the problem rather than cover up the symptom. But sometimes you have to cover up the symptom in order to fix the root of the problem.In particular, chiropractic never helped many of my health issues except straightening out my sacrum. I have extreme sacrum pain and an adjustment once a month (or less) works wonders. I too am sick of drugs so I just keep myself as healthy as I'm able.

a small response to the anonymous about in the middle of the comments. i come from the other side. i fix the f#@k ups of the alternative 'healers'....regularly. the fact that there are even statistics about iatrogenic deaths is a feather in allopathic medicine's cap. i have personally seen many deaths from alternative 'medicine', but never even one statistic. it must be great to stand behind mumbo jumbo and statements about infinite possibilities to hide your killings. at least we are accountable. just a thought. use it. don't use it.

anon: I assume OMT means osteopathic medicine something. I have come to see osteopaths as roughly equal to MDs, in that their approach to medicine is pretty much the same. The clinic in which I was a partner has several DOs on staff. Given the apprehended difference, I still wonder why, if a person had options in either direction, one would choose to get a DO over an MD. I guess that reflects some degree of remaining prejudice on my part.

fp: entitled? Well, since it appears to be a human trait and need, I guess that's as good a word as any. Even though in these times we need a lot more logic than we as a nation seem able to muster.

Interesting post Dr S.-I have a friend that was healed of Lyme disease with alternative medicine because she is allergic to antibiotics.

Forgive me for making theological points as I understand them in response to my interpretation of your post. I am not here to proselytize.

You said:At some primordial level, is it just that we need to believe in silly stuff? What is it about humankind that pines for magic, for simplicity, for answers that pave over the painful?

First I just want to state that anything I am saying here is through my Christian perspectives. When it comes to theology, there could be so much said from just one sentence so I will try to stick with the readers digest version. Theology is a deep, deep topic which is continually revelatory, perhaps why the Bible has been referred to as The Living word. :) I am only bringing this up because you've lumped faith in God with a whole lot of negatives that quite frankly I and many God believing people have no part of. I said God believing because there are many good people who believe in God that are not Christians. I in no way wish to offend anyone or force anyone to see things my way...even... if I am right. ;)

Back to your question, I think it is because we were all created with a void in us that was meant to be filled by God but again if we don't, then we will continually try to fill up with things that will not give permanent satisfaction or lead us in wrong directions. Our spirit looks for fulfillment from God. This created void was meant to cause us to willingly seek him.

You said:Why isn't inquisitiveness universal; doesn't skepticism confer survival benefit? Or would we all be jumping off cliffs if we didn't have mythology?

I agree with you. We should question things and not run with every changing wind or like lemmings off a cliff. Actually, Paul (responsible for a good part of the New Testament) said that we should "Test all things; hold fast what is good". We are supposed to be discerning and not just run off with what tickles our ears.

You said:Given that there are about six billion people on the planet who believe something else, and with just as much certainty, I find it amazing. And revelatory. It's a need. It's built in. It's human.

I don't think all 6 billion people are correct in their beliefs but neither do I think all 6 billion people are wrong. Again what you stated about it being a need, built in and human ties in with the God given void.

You said:And now, as society has gotten impossibly complex, and the dangers are mostly human-generated, it's become a detriment. Rather than helping mankind to cleave together and help one another, magical beliefs -- whether on couches or in the clouds -- are causing us to fall upon one another in hate, in fear, in the unreason that comes from a mind blown by the awful realities we have brought upon ourselves.

I would always lean toward medicine but I also wouldn't discount some alternatives. But I am not disagreeing there.

I take issue with the clouds part as I interpret that to be believing in things not yet seen, i.e., "faith". Please correct me if I am wrong but it seems to me like you are lumping anyone with faith in a higher power with all the evil and destruction. I must be misunderstanding you. Anyone following the scriptures would not "intentionally" harm anyone else. Yes, sadly we have to in war or when defending the innocent. There has to be consequences to crime, etc. We are supposed to love one another.

There were/are a lot of things (terrible things) man has done in the name of God...that God had/has no part of.

He gives us free will. Free to choose him, reject him or make up our own rules about him to justify our bad behavior.

The scriptures talk about man being given free will. Meaning that God does not force us to believe in him and that he did not create us to be automatons. He wants people to "freely" choose him just as we want someone to love us because they want to be with us because they truly desire us and are not forced. Then you have a joyful relationship because it is mutual. There is a saying and that is "The Holy Spirit is a gentlemen" meaning he doesn't force himself on anyone.

I said all of that because I want to point out that the terrorists flying into buildings would force us to follow their faith, their belief systems if they could. FORCE! Evil seems to prevail sometimes but there is so much goodness too. We are supposed to love one another.

I don't think one has to reject all science and technological discoveries just because they don't embrace evolution. There are scientists out there that don't believe in evolution.

The following is known as the love chapter and is from First Corinthians, chapter 13. (This is what people who love God try to do. We are imperfect because we are human. Jesus said to love one another as our selves. Certainly that isn't trying to bring harm and hurt you or anyone else.)

Love Chapter-Icor:13

1. If I speak in the tongues[1] of men and of angels, but have not love, I am only a resounding gong or a clanging cymbal.

2. If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but have not love, I am nothing.

3. If I give all I possess to the poor and surrender my body to the flames,[2] but have not love, I gain nothing.

4. Love is patient, love is kind. It does not envy, it does not boast, it is not proud.

5. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs.

8. Love never fails. But where there are prophecies, they will cease; where there are tongues, they will be stilled; where there is knowledge, it will pass away.

9. For we know in part and we prophesy in part,

10. but when perfection comes, the imperfect disappears.

11. When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put childish ways behind me.

12. Now we see but a poor reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known.

13. And now these three remain: faith, hope and love. But the greatest of these is love.

There are well meaning Christians who will say that the world and man is only 6,000 years old (started with Adam and Eve) when science has proven otherwise. I have heard scientific explanations that reconcile the true science with the scriptures and they are interesting points to ponder.

Faith is believing in things not yet seen. It's not magic it is faith. Just because God can't be proven does not mean he doesn't exist.

I don't think one has to reject all science and technological discoveries just because they don't embrace evolution. There are scientists out there that don't believe in evolution.

Someone else who clearly didn't read to post.

That there are scientists that don't believe in evolution says nothing about evolution, and much about those scientists. Not believing in evolution does not make the data disapear. In this case, faith would not be defined so much as believing in something because it has not been disproved, but rather as either willful ignorance of the available data and the power of a theory to explain it, or deliberate self-deception leading to the same result.

Love may well be a nice thing, and it's a pity more religious people don't remember those lines, but love for ones fellow people does not require religion, and says nothing about the truth statements of those religions; and, for that matter, has absolutely no bearing on the truth of falsity of evolution, or any other scientific endeavour.

By making a long statement about love, and equating it somehow with an apparent rejection of evolution, you're simply saying "I want to pick which science works. I want to be able to choose how the world works to satisfy my religious belief. I want to deny the reality of the data in those specific instances where it doesn't fit my pre-conceived notion."

Incidentally, regarding theological points, remember the second commandment (second-half of the first, if you're catholic):

"Thou shalt not bow down thyself unto them, nor serve them: for I the Lord thy God am a jealous God, visiting the iniquity of the fathers upon the children unto the third and fourth generation of them that hate me."

I don't think you should get to pick and choose. Don't believe in evolution? OK, then don't get on an airplane. Earth is twelve thousand years old? Fine. Take back your laptop. Homeopathy makes sense to you? No problem. Put down that cellphone, never avail yourself of GPS. Because if man and dinosaur occupied the same space and the same time, if carbon-dating is bogus, atomic clocks don't work and transplants are impossible. If vaccines cause autism, Rovers aren't on Mars and nothing will happen when I push the button to post this.

That's exactly the point I was trying to convey to one of my blog's favorite trolls. Despite all the branches being labeled, science is more like a web of interrelated knowledge. If evolution is wrong because of unspecified problems with carbon dating, it would mean that atomic clocks and RTGs wouldn't work. That would mean NASA and GPS are just a big crock.

If Creationists expect me to believe that evolution is a fraud for reason of alleged problems in carbon dating, they're asking me to believe that the space program and the little tool I used to find the way to my brother's house are equally fraudulent, because they're in some way or another based on the same thing they denounce in evolution.

The anthropologist Pascal Boyer pointed out that non-skepticism (not anti-skepticism) would have a survival advantage for early humans. That is, we are a species that recognizes patterns (even if they aren't really there, as in pariedolia). A human that saw a pattern and reacted without stopping to examine it would run away from the leopard sooner. They'd also run away from non leopards a *lot*, but that's where confirmation bias comes in.

Armchair dissident- I wholeheartedly agree with you that one does not have to be religious in order to show love. You are so right! That is a ludicrous thought. Apparently you didn't understand what I said and so I shall try to be more articulate but I appear to be up against great minds so do try to be patient with me.

I was defending religious people in that there is much good done around the world in the name of God by beautiful people that love him and love their fellow man. Love comes in all forms and through various means and I would never deny that. NEVER! And I am grateful to those people. I am grateful for any goodness brought about...even the good that comes out of bad.

I worked with a wonderful doc who was a professing atheist. He was a wonderful man and a great doc. We used to get into these theological discussions where in the end great minds have to agree to disagree. One night he said "Ahhh...your naivete is refreshing" and I said "ahhh...your ignorance is amusing." ;) We were friends with different opinions. I can think of a lot of people that have crossed my path or are in it now that don't believe in God or they are agnostic and they are kind decent people. But to equate a good part of the ill in the world to people of faith when most of us understand that it is a rotten few or extremists is surely unfair and inaccurate.

I am in no way equating evolution to love. I don't believe in evolution so for me it is a moot point and therefore nothing to connect. And even if I did, I wouldn't equate it with love. BTW...I do not discount evolution because of my theological beliefs.

Do I believe in carbon dating? Yes! Do I believe there is proof of human existence prior to Adam and Eve who lived approximately 6000 years ago? Yes! Do I believe in the amazing scientific discoveries? Yes! We have witnessed them and we live with them every day. They are concrete-faith is abstract. There is also scientific evidence that a great flood occurred around the world too.

All things are possible. The Hubble,satellites and this www-amazing! I don't limit science and I don't limit God. I am grateful for both.

I am not catholic but I am a Christian who embraces the Judaeo/Christian ethic. Anyone can pull a verse out of context. It is important to know the culture of the time and preferably with translations from the original Greek or Hebrew.

Jesus was the example. They didn't kill him. He surrendered his life. he taught us to turn the other cheek, to forgive 70x7 (which means indefinitely), he said no greater love does a man have for another than laying down his own life. When the Pharisees tried to trip him up by asking him what the greatest commandment was...that is when he wisely covered all the bases and said to love one another as your selves. (If you do this you won't break the commandments because if you wouldn't do it to yourselves then logic follows you won't do it to others if you follow that commandment.) Jesus was a radical for his time and I suppose would be today to. He never took the popular road but went to visit and socialize and basically love those that were looked down on which were prostitutes, tax collectors, lepers and people I am not remembering. When he was before the court all he had to do was defend himself but he didn't because he knew he was going to have to sacrifice his life...that is how much he loved mankind. And even if anyone wants to say , yeah he was a psychwack with a death wish. No he wasn't, not if you read about his experience in the garden of Gesthsemane. And if anyone wants to put him in the same category as the extremists for their faith well then the huge difference is...Jesus laid down his own life for what he believed- believing it would help save others. Jesus did not take the life of any other human being never mind innocent people. If you read anything about him you will know that is not the message of the gospels. We are told as Christians to follow his example. Do people fall short? Oh yeah! But if we follow his example (true Christianity) then we will LOVE our fellow man. First John is known as the book of love and is a great way to introduce one's self to who Jesus was/is. If anyone is inclined to read for themselves then I recommend the NIV version of the Bible because it is closest to the original Greek and Hebrew and there are other contemporary versions as well. King James is poetic but isn't the most accurate translation although I personally believe God will see your heart and honor whatever you read. A lot of people "know of" God but they don't "know" him and that is a huge difference. And anyone can know him if they choose to...anyone.

Also, I have seen and there are many stories out there where people have had total transformations changing their lives for the better when they became Christians. I mean totally turning their lives around and really caring about their lives and others.

I want to reiterate that I do not have a problem with science. Just because I don't happen to believe that we all evolved out of some primordial goo does not negate the scientific discoveries we have before us. My personal opinion is that it takes a lot more imagination to not believe in God. Just look around. The complexity of the human body itself and anything else you choose to appreciate or study. If this earth were off in it's rotation just a little we wouldn't exist. The cycles and seasons. We live in 3and 1/2 dimensions...time-we can only go forward,height, length and width. The last I knew and this was years ago, astrophysicists believed their were something like 12 or so dimensions but we are limited on earth. There is so much we don't know and so to think that our finite knowledge by comparison is the basis for the nonexistence of God ...well, I just can't embrace that line of thinking either.

I suspect that most of you who come to this blog could do intellectual circles around me and I don't pretend for a moment to understand everything and I know I have much to learn. But I am a discerning and reasonable thinking person. And I am a loving and kind person who does have a strong faith in the things not yet seen. I promise you that my belief system will never cause me to hurt you but rather to look for ways to help you or be a blessing.

My appologies to the good surgeon if this is not the place to continue...

I am in no way equating evolution to love. I don't believe in evolution so for me it is a moot point and therefore nothing to connect. And even if I did, I wouldn't equate it with love. BTW...I do not discount evolution because of my theological beliefs.

Then please do enlighten me as to why you discount a branch of science that has: the data, the minds of those thousands of brilliant people who work within biology, and the discoveries that are consistently being made that make sense only within the context of evolution.

You can't say "I don't have a problem with science", and then say "I discount evolution" and still be consistent. If you discount evolution you have either been severely misled and misinformed, or you have a problem with science.

All things are possible. The Hubble,satellites and this www-amazing! I don't limit science and I don't limit God. I am grateful for both.

But you do. If you "discount" evolution you are limiting the scientific view on the origin of species. You are - by definition - limiting science. You are admiring the bits you like and shunning the bits you don't.

There is also scientific evidence that a great flood occurred around the world too.

Really? Let's be sure we're using terms consistently here: are you suggesting that there is credible scientific evidence for a flood that affected the whole world at the same time in all places, as per the biblical flood of Noah?

I am not catholic but I am a Christian who embraces the Judaeo/Christian ethic.

Then you'll be delighted to know that that's most likely your second commandment then.

Anyone can pull a verse out of context. It is important to know the culture of the time and preferably with translations from the original Greek or Hebrew.

Far from pulling a verse out of context, that is the precise rendering of the second half of the second commandment as written in Deuteronomy.

They didn't kill him. He surrendered his life.

Erm, no he didn't. He knew in advance he would be resurrected. He slightly inconvenienced himself for a few days.

he said no greater love does a man have for another than laying down his own life.

He also said "I have not come to bring peace, but to bring a sword, to set father against brother". He also said "If you do not hate your father and your mother, you cannot be my disciple". Once again, we can all cherry pick when it comes to religion to make it look like what we want it to look like. You just don't get to do that with science.

If anyone is inclined to read for themselves then

Please be assured that I have read the NIV. I would agree that the KJV is more poetic, but it was just too damned long winded to read the whole way through - the NIV really is better suited to that task. I simply don't believe it.

Also, I have seen and there are many stories out there where people have had total transformations changing their lives for the better when they became Christians.

And I can tell stories (including my own) of people who turned their lives around for the better after noticing that religion is seriously and fatally flawed. Neither stories says anything whatsoever about the truth of our position, and are simple appeals to consequence.

But I am a discerning and reasonable thinking person. And I am a loving and kind person who does have a strong faith in the things not yet seen.

And no-one is suggesting otherwise. What is being pointed out is that science is not a pick'n'mix stool. If you want to admire the wonders of the physical sciences, but not the wonders of the biological sciences, then you really have no cause to complain when people point out all the nasty things in religious texts and leave out the nice.

I've written elsewhere in this blog that I've seen faith be helpful to people in distress, and as a surgeon who has to deal with it, I appreciate it. Nor is it my intent (were it possible) to rob someone of her faith. (In fact, I used to post in a religious forum a click away from a medical one, and after several back and forth posts with a very religious person, in which I stated the inconsistencies I found in the Christian view of god, he finally said I'd caused him to lose his faith. I never posted there again.) I know plenty of people of faith who are good and thoughtful and, in most things, open-minded. Admittedly my tolerance has lessened as I see an increasing role of public faith, a religious test for all politicians, and witness the destruction of our country -- in values, in perceived goodness around the world, in belief in the essential tenets of democracy, in financial strength, in intellectual strength -- which has been wrought by our publicly religious president who says god told him to invade Iraq. Public faith is ruining our country in the name of saving it, and I can't be silent about it. Hell, I can't even sleep any more. There are more than enough places for people to pray and to talk to god; they ought not need to in politics.

People who are able to ignore obvious inconsistency, who simply wipe evidence off the table with their bibles, are dangerous when they are in the public arena. In making policy, we not only don't need that, we can't afford it. I'm not entirely against religion: just religion as public policy, whether it's flying into buildings, invading countries, excluding gays, censoring science. It's all supremely dangerous. And, like heroin in our veins, to some it feels good until it's too late to recognize what it's done.

Finally: I don't much like the idea of commenters attacking one another here. I have in the past deleted a couple of posts that were too personally offensive toward another commenter. I welcome discussion, and I assume people who engage in it can handle themselves. If people attack me, I can respond or delete, because I havet the button. But it makes me uncomfortable when inter-commenter dialog gets nasty. I sit with poised finger.

WOW, so much to say, where to start. I used to be a man of faith/religion, raised mainstream christian (methodist). I used to fight for GLTB issues in the church. To paraphrase the rock group REM, "I lost my religion". But that's not what I want to discuss. I think I'm in a uniqu position to comment on this particular posting--partly for the afore mentioned, but also, I have been a patient of traditional (western), alternative, and eastern medicince. To bullet point the last five years:*chronic pain as a result of lumbar radiculopathy (L5,S1)* pilonidal cysts (2x in 2 yrs)*surgical neck fracture of the humerus (from a fall on the ice)*diagnosis of CVID (Common Variable Immune Deficiency) --a congenintal disorder that was finally diangosed, has nothing to do with any sexual behaviorThese are the biggies, I'm leaving out the lesser issues and anything that was more than 5 years ago. I'm a reatively young man for all of this to happen. I had just turned 40.I've done chiropractic, acupuncture, deep tissue massage. I've had steroid injections in my spine, and have been on so damn many meds that Walgreens should own stock in me or at least be giving me frequentflier miles (or meds). My issue with chiropractic (and this is a generalization that I know is NOT universal), is the unwillingness to admit when they can't help, but keep scheduling you for return appts., up to 3x/week. I have benefitted from acupuncture and would readily recommend it. I DO think there's a lot that Western Medicine can learn from Eastern Medicine. Massage, I think is just a good thing for the body and soul. I had a physical therapist that I saw for shoulder problems (>5 yrs ago), who I referred to as my "Voodoo Witch Doctor". This man knows his stuff. He knows human anatomy and how everything is interconnected better than(or as well as) many Orthopedists. He would do these crazy funky maneuvers/manipulations on me--on areas of the body not directly related to the pain or infirmity. He continuously blew my mind with the things he did, AND THEY WORKED! When I broke my arm/shoulder I would only go to him, even though I had to pay out of pocket.Sid, all things being equal, I would opt for a DO over an MD, especially as a PCP. My feeling is that a DO thinks more wholistically, in treating the ailment. I think they approach the patient/ailment from a different mind set, and I like that. My current PCP is an MD; my PM&R, a DO; Surgeons have all been MDs. In a previous position when I worked with Residencies, one of my Chief Residents was a DO. His approach was different than the previous MD chiefs. Everytime the next medical thing would happen to me (I'm a walking CPC), well meaning people would somehow try to attribute this to "GOD". Sometimes it took every fiber of self control to keep from telling them to go F*#@ off. There is a quote from the TV show EVERWOOD that was on a few years ago, when one character told another that she would be praying for her husband's illness. The recipient replied, "Thanks just the same, but I prefer to put my belief in science." I'll end with that.

I found this through a link of a much less balanced skeptic, and I'm glad I followed it. A couple of thoughts for you:

Regarding the sad post of the clearly delusional chiropractor with the dying wife, I think that you'll find that even the most ardent skeptics can change their behaviour when facing death themselves, or when facing the death of someone who they are emotionally attached to. I highly doubt that man was thinking anywhere near clearly, and really, it is extremely difficult to have an objective perspective in extreme situations like that. I haved watched something very similar (though not to the same extreme) happen in my family, where denial of a normally very logical and sane person, completely clouded all objective judgements, until the inevitable end came.

One other thought comes to mind reading your post about the changes in medicine. As you noted in another comment above, Western Medicine does not have answers or any good prognosis to provide to people who suffer from many difficult, and painful afflications. The human mind will naturally look anywhere for hope when faced with death or pain. I would posit, that in the not so distant past, a lot of people viewed Western Medicine as magic regardless of it's scientific or evidenced based roots (although historically there was less evidence in numerous cases). I think that in the past, the medical community did not take any efforts to change this view of the profession.

However, the times have changed. As your post notes, technology abounds, and you can't hide from it, so the magic of medicine has faded (although I still regard some treatments with awe) and thus sick people are doing what they always did. Look for hope. Except, Western Medicine no longer offers it to many of those people, so they look elsewhere.

I ran into this magical thinking at work just yesterday, when a management level co-worker in an IT position at a large corporation swears that the ancient Greeks hunted dinosaurs. I blogged about it in a humorous way, but I was dumbfounded.

Is the rise of woo in medical schools anything to do with the growing assessment culture in universities? Or for that matter, in medical practice? I ask because I am frustrated by the silly surveys my HMO sends me after I've visited my physician asking me "beauty contest" questions that boil down to "is the doctor a nice person." I usually go off on a rant to the effect that, "I don't care so long as the doctor is competent," but I have often wondered whether mainstreaming woo is a way of upping "happy" scores on evaluations like this. And, perversely, it would make sense, since the anthropological literature shows us time and time again that a: the ritual parts of cures are acknowledged even by the practitioners to be smoke and mirrors to engage the patient, and more importantly, the audience; and b: the ritual is just the most flamboyant part of the cure, the less obvious part is the extensive "talk therapy" -- if you like -- that goes on before and after. In other words, the psychological outcomes may be more important than the physiological ones.

Anon: good question. "Assessment culture" is, I suppose, another way of saying, as I did, that they're in it for the marketing. Give 'em what they want. And whereas, as you imply, there's a role for addressing broader issues that may effect a sense of well-being and therefore conceivably affect results, it could be done with much less credulity or cynicism, which ever it is in the case of those med school. May as well have a device to kill virus eggs.

When I look to the night sky, I see globes of gas so immense they squeeze atoms together; radiation passing unimaginably fast, and yet taking years to get to my eyes; a galaxy whose light was born when my ancestors weren't very different from apes.

In a box in my closet I have a fossil trilobite. Not a very remarkable one, but it is nonetheless the actual remains of a real creature that scuttled on the sea floor hundreds of millions of years ago. Those remains never saw the light of day until they were exposed soon before I found them.

I see a plant, look closely at it, and see it as part of a family with many and varied members, not just "a weed" as my mother would call it.

How can you say that my view of life is bleak?

(no offense taken, BTW, just a disagreement over what is or should give "meaning" to life.)

John: I'm trying to find where you found that "bleak" quote. It's not in what I wrote, and I can't see it in anyone's comments. (My wife has to find things for me. Usually, though, they appear as soon as I say I can't locate them.) In any case, I hope you are not attributing the thought to me, because it couldn't be further from what I believe. Nor did I imply it, any way I re-read what I wrote.

I must go to the wrong chiropractors. I've been to 4 or 5 over the past 15 years or so, and not one has ever tried to cure cancer, or swung crystals over me, or any of the other things I see skeptics raging about online. They do light massage to loosen cramped muscles and then adjust the bones that the muscle spasms have pulled out of place and caused to pinch nerves which is causing pain. It's a very simple, linear process and almost always provides more or less instant relief. It's not an "alternative" medicine any more than massage is an alternative form of muscle relaxation, and it often puzzles me when I see skeptics (of which I am one) flaming on about chiropractic. I'm sure there are kooks and gurus out there, but I worry about sensible people living with chronic neck/back/joint pain when they could easily be fixed up with some simple massage and spinal adjustment, and maintain their health with stretching, proper exercise, and improved ergonomics in their work environment.

Simple testimonials: Years ago I had a very sore neck for weeks after separating my shoulder in a snowboarding crash. I was holding my head at an angle without realizing it, which it took a chiropractor to point out, and after a few weeks of regular treatments my head was upright again and my neck/shoulder pain was gone. Last weekend I crashed mountain biking and suffered through painful, sleepless saturday and sunday nights due to a strained neck and upper back that no amount of hot baths and stretching and flexall would entirely ease. I visited a chiropractor on monday and got some massage and electrosound on my neck, and then some adjustments, and I felt fine and slept normally Monday night.

as I said in the original post, I agree that manipulation is useful for certain things. Chiropracters that stick to that, and in appropriate situations, are just like physical therapists, which is also useful. It's those, like some mentioned in these comments with their mumbojumbo and electric devices and god knows what else, and who claim that manipulation cures all manner of other ills, that are, clearly, bogus, scam artists; dangerous deceivers.

That magickal thinking you talked about in your post is still very apparent here in my country. People would readily believe what the local quacks would say about how they can get rid of gallstones without undergoing surgery or taking medications by just taking in a wonderful concoction (specially mixed by them, of course, and for a "little" fee) while they'd turn up their noses at what doctors would advise to them, even if they have heard the same advice from different doctors.

Dr. Sid; Spot on! As a father of 4 children, one of whom is autistic, I've been barraged with alternative therapies for our autistic child including gluten free diets, witholding vaccines, chelation therapy, vitamin therapy and on and on. Some Autism organizations are spending (wasting) huge dollars promoting and attempting to prove these snake oil therapies and woe to anyone who dares challenge them regarding the efficacy of these treatments. My wife has attended a few seminars promoting alternative therapies for autism and always comes back excited about one thing or another until I ask her to show me the data and run it by our Developmental Peds doc...although she wants to "believe" like a child waiting for Santa, she fortunately comes around to common sense and proven practice and the medical fad of the day is no more for her or our daughter. On the other hand, perhaps a chiropracter's adjustment will get my little one to speak ;-) Great stuff-I'm looking forward to reading your book over the holidays.

I go to a chiropractor...he's very good. When I put my back out so badly it hurts to move (which I do fairly regularly), he can put it straight again.But that's all he does.If you're having back pain, he'll try to fix it, and if he can't fix it he'll refer you to a medical expert in the appropriate field.

Many chiropractors are complete quacks who claim to be able to treat any medical condition under the sun, but a few of them are actually practicing honest medicine.

Great post, Sid! I am so with you on the CAM stuff. While I am all for anyone using something harmless if it makes them feel better, don't call it science if it isn't.

The blogger at Rebuild Your Back wrote an excellent series of posts recently entitled "Medical School or Fraud Factory? An Inside Look at Chiropractic College". (the link is: http://www.rebuildyourback.com/chiropractic/school.php. I'm no good with the html thing) It really opened my eyes to what goes on in chiropractic training. No wonder so many of them are charlatans. (mandatory disclaimer: Which is not to say that there are not some good chiropractors out there who help people in pain with spinal manipulation. Likewise, OMT (osteopathic manipulation therapy) is helpful for certain conditions.)

I have a brother who sells supplies such as vitamins, orthotics, accupressure devices, special pillows and all that. He sent me a link to a chiropractor in Minnesota who advertises that he can reduce the incidence of certain types of epileptic seizures (not partial-complex, which my daughter experience until she underwent a frontal lobectomy.)

I went to the chiro's site and didn't find anything at all, any papers, any links to studies, any contraindications, any statements by neuropsyche's or anything at all to support that the treatments had been successful or had any link at all to the cause of the seizures.

So, I wrote my brother back and said that the problem I have with chiropractic. I just have never found any studies that support the efficacy of the treatments. I agree with some writers here that chiropractors can be effective physical therapists if that is where they limit their practice. I think that orthopedics can ease back pain and I always wonder if acupuncture does have more to it than just tapping into "energies."

His response back was blistering and angry. He has taken my nephew to chiros for earaches. He refuses to use antibiotics because of the evolution of superbugs and sepsis and doesn't want to contribute.

He studies and practices nutrition and I trust him on that. But he thought that because I don't accept chiropractic as a medical field that I was attacking him. Ours was a short exchange because he made it so personal, and I told him I refuse to discuss it with him any longer.

I have run into chiropractors who claim that they have cured infertility; who claim that all of the nutrititive value in our foods has been reduced by 95% since the advent of industrialized farming and that the only solution is massive vitamin supplement along with macrobiotic shakes.

Thanks for your post. My brother is rational in almost everything except for chiropractic. When I suggested it was because he makes a pretty good living supplying their customers he was, perhaps rightly, incensed.

I came here because of Greg Laden's link to PZ Myers' link to Orac. You are hereby added to my RSS feed and my blogroll, Dr. Sid.

I love your blog. I had an interesting medical experience related to magical belief last night, and I was wondering if you might be interested in visiting and possibly commenting. I've seen some of your comments on my blog before, and I hope you'll return.

As of yet, I don't really know how I feel about this post. What comes to mind after reading this post is the saying, "All things in moderation..." It seems that in this post, the good Dr. (whom I am certain is very good, actually) has lost that idea almost as much as those whom he rants about. As a Juvenile Diabetic on insulin pump therapy, (obviously) I'm in and out of doctors' offices more often than Hollywood turns out a horrible remake of a good original...:O) Sorry, I couldn't help myself... :O) So, let's just say it often feels as though I'm on good terms with the entirety of the medical community in whatever city I happen to be living in... I just moved to where I'm at, and as of a week ago, I'd already been to four - count them - four, specialists, not including my PHP. And I'm *HEALTHY*. I do not have any complications of Type 1 Diabetes.

Being on an insulin pump, I live only because of where medical advances have gotten us, and believe me when I say that I am exceptionally grateful that I don't have to take 5-7 shots of insulin per day. That having been said, I keep informed about "alternative medicine". I take (some) vitamins and I was often taken to a chiropractor as a child and went as a younger adult, and never had any ill-effects, in fact, quite the opposite.

Several scientific studies have linked the onset of Juvenile Diabetes to the wonders of medical vaccinations (which I was severely allergic to, I might add), among other things. Scientific studies have also shown that a high intake of cinnamon is effective in lowering blood glucose levels. If that's not an "alternative," I don't know what is. Although I know it won't cure me, I've been good friends with cinnamon for some time now, with good results. :O) So, although I have a strong belief in modern medicine, if, however, one scientific study (or even a backwater medicine man in the heart of the Amazon will do) offers me the opportunity to live my life as a diabetic without injections, I'll be the first to sign up. If it doesn't work, fine, I'm not going to let my body kill itself by refusing to take my insulin... "All things in moderation..."

Let me also state for the record that this is all being said by a person firm in her (more Judaeo than Christian :O) faith. Ironically, my user-name seems to really play into the "magical" thing. Maybe it's just too late at night, but I find that really funny. :O)) So, do I believe in God? Absolutely. Does He have the power to heal me? No question. Will He? I have no idea. I certainly hope so. Will I drop all my meds and start smoking whatever an herbalist tells me because I believe God will heal me due to that "faith"? Forget it. Simply because I am a person of deep faith doesn't mean that I chuck my common sense out the window. If anything, it requires that I am more diligent to use that sense. Anyway, as frequently... No, *more* frequently than the Scriptures (because the Scriptures have not been added to in any significant way for some time, and medicine is still evolving - no pun intended :O) medical science frequently contradicts itself... One study shows one thing, another shows something completely different. To use a somewhat silly example: are eggs good for you? Why yes, they actually are, but 15-20 years ago, they were one of the most vile foods that could be eaten (at least according to the family's doctor and my grandmother who followed his every word)... Again, "all things in moderation."

It feels as though the common sense which has been commented about has been lost here. It seems to me that in order to be a physician there must be some sort of faith... Perhaps none identifiable with a religion, but to trust in nothing other than science, which is fluid and mutable, takes at least as great a faith as someone who believes in nothing other than the Bible, if not more.

To me, there is no reason why faith and science, particularly medical science, can't live side-by-side. Much of what is modern science was born out of faith, and still is today. How many scientific researchers follow their "hunches," belief in things that were not supported by the facts of the time, only supported by their ideas and perhaps a few clues? Then they go on and uncover the facts that back up those hunches through their research... Simply because one chooses not to believe that they can do something like that doesn't mean that that is impossible. It's just a choice. Simply because the existence of God has yet to be proven doesn't mean that it never will. One hundred years ago, people would have laughed at the lunacy of someone who dreamt of walking on the moon. It was impossible. It could not be done. And yet, here we are on the other side, unable to dream of any other reality. Not so much further in the past than that, the sun and planets revolved around the earth - it was unimaginable that it could be otherwise.

So, do I put stock in science, in hard facts, in the wonders of the medical world? I wouldn't be alive if it weren't for them. But I can say with absolute certainty that I wouldn't be alive without my faith either, and choosing not to believe in anything is, in equal rights, its own form of faith...

It seems to me that although you say that you don't believe in picking and choosing, Dr. Sid, in essence, you actually are... I don't really know how to eloquently verbalize all that I am trying to say (it is close to midnight here and old fogies like me should be in bed), but I guess after reading this post, it felt like moderation was left in the dust, right along with all the alternatives that might just contain some grain of truth, just like all the "fairy tales" of faith that you are choosing not to believe in.

Please know that this is said with the greatest of respect in mind, and I am very interested in reading any responses that might come my way. :O)

Empress F: I appreciate your thoughtful comments. I've written several times on various aspects of faith on this blog; in particular where it intersects with medicine. I recognize the strength it gives people when facing tragedy, for example. The intersection of faith and science is an interesting subject. Having grown up Jewish, even considering (a typical adolescent thing, I'd say) becoming a rabbi, I now have gone to the other extreme. Nevertheless, I don't dismiss the faith of all others.

My issue is with those who reject what is obviously true, in order to maintain faith. I think religion ought to help us deal with the world as it is, not make us reject it. The examples I used in this post, ie the age of the earth, evolution, etc. really disturb me. In order, for example, to insist the earth is 12000 years old you have to reject science that applies widely elsewhere, which is why I made the somewhat facetious comment that if you think the earth is 12K years old, you shouldn't fly on planes. I note a comment on reddit that that's illogical, but I think the commenter missed the ironic tone.

I commend you for your strength in dealing with your diabetes, and I'm glad you are benefitting from the continued scientific advances in the field. I'm sure more will come. Were you to reject insulin in favor of cinnamon, I think there'd be trouble. (I'd be interested in the actual "scientific" studies to which you refer. My guess is they aren't in peer-reviewed mainstream medical/scientific journals, but I'd be happy to be shown wrong.

Thanks for your response... It was very insightful. :O) I wanted to address two things that you mentioned in your response, very quickly. I far better understand your position on faith, particularly in regard to medicine now. I appreciate the clarification, and I agree with what you say.

There is a place for blind faith, yes, but in regard to medical necessity, I believe that as a rule, refusing treatment for the sake of belief is generally foolhardy. I'm sure there is a place for that, but it is something that should be practiced with extreme caution, and, according to my beliefs, much prayer. :O)

Also, you were interested in the studies about cinnamon, so here is an article I found:

http://www.newscientist.com/article.ns?id=dn4413

It has a link at the bottom to the journal-published study.

Now, I will say this - this study was done in Type 2 Diabetics, and from what I understand there has been a more recent study that has shown that the use of cinnamon has no effect on Juvenile Diabetics... However, I disagree, because in my personal experience (I don't eat cinnamon every day, but it has become a close friend, as I had mentioned) I have low blood sugar episodes *MUCH* more frequently after eating something with a healthy dousing of cinnamon than if I eat the same thing without it. I personally believe that this new study did not use enough cinnamon - if you look, the amount used in the Juvenile Diabetic study was the very smallest dose used by the study in the Type 2 Diabetic study... But this is just my opinion and my experience...

So there you have it. :O) Take care, and I'll be checking for more posts, I'm sure.

Your last paragraph is something I've been saying for years. As a pre-med student at UC Davis with my minor in religious studies :), its hard for to understand how people could come to such a place a university and still hold these beliefs. In my biology class people protest when we don't study intelligent design, its just amazing to me that you can pick and choose what you want to believe, seemingly when it becomes convenient. Why come to a hospital anyway if you believe that God knows better? Obviously, this issue is pretty dense and I'm probably not going to get my whole point across, but I really like reading your blogs and this one especially resonates with me.

I think your post is all or nothing. See most religions, believe their god created this world, which includes science, most religions believe god is everything. He created it, so basically you can call it evolution, but evolution to religious people is a part of god, as it is his creation, people who don't believe in a god, explain as evolution. You will never know the truth, until you die. later.

No I guess you don't need to die to understand evolution, but for indefinite answer to the latter is there a god? Well I guess an atheist might. No offense, I respect your view and others, I just have my own. No harm no foul. I enjoy your posts.

Nice blog. Believe it or not, there are skeptical chiropractors out there who try to practice in as evidence based a manner as possible -- some of us even blog about it. I'd love to see the wackos stop giving the field a bad name and use their salesmenship skills to go sell used cars. Cancer? Ear infections? Autism? Puh-lease.

Dr. Sid: I love your writing, and want to thank you for creating this blog; I've enjoyed pretty much every corner of it, and found much of your thinking refreshing and interesting, and your approach to surgery as an intersection of art, skill, and sacrament to be an incredibly powerful image. That being said, I have to disagree with your premise here: I think that you're confusing evidence- or science-based with "every avenue has been explored". The fact that some treatment is not a part of the current medical repertoire does not make it quackery; for that matter, the fact that it is a part of current medical practice does not make it *non*-quackery.

Example: I was born and grew up in Russia, where medical access was scant, the availability of supplies was an amusing myth, and doctors had to work their hearts out to accomplish anything positive. As a result, folk and herbal medicine was the standard - and much of it (about the same percentage as the allopathic medicine - but that may just be my native Russian-Jewish cynicism coming through) actually helped, with positive results "documented" anecdotally. E.g., the "Greater Plantain" (I had to stop and look up "подорожник" in Wikipedia.ru) has an obvious coagulant and anti-inflammatory effect, and pretty much everyone in Russia knows it through personal experience. I certainly do. Is it part of the standard medical procedure here in the US? No. How about gentian violet? Every Russian has it in their medicine cabinet, and it's useful for everything from a topical antibacterial agent to stomach upsets - that's just plain fact. Is it used much in the US? Good luck finding it... and yet, it's much better than anything else you can find for handling thrush in breast-feeding moms and infants.

Now, I agree that herbal medicine has been co-opted by what I call the "woo-woo" set, and that they make ridiculous, insane claims (and back those claims with insane practice) about it. That still does not mean anything about its actual effectiveness - otherwise, the fact that surgery was used by the Nazis would make it evil and worthless.

You have a very fine mind that can make incisive distinctions and ethical decisions that would befuddle most other people, assuming that they could perceive the problem in the first place. Please don't let your outrage against the idiots blunt that fine edge; lack of evidence does not and cannot mean "evidence against".

Your points are good ones, and I don't think we disagree much. My point is that if it works, it's not "alternative medicine," it's "medicine." There's no doubt traditional medicine has its faults; but the difference is it tends, over time, to correct them. Studies are done. Time honored treatments are found wanting, and discarded.

Not only that -- especially recently -- scientific medicine welcomes testing. Alternative medicine not only doesn't, but when legitimate testing is done (nearly universally by other entities) and finds it to be no better than placebo, the practitioners thereof continue it anyway.

I think I recall having gentian violet used on some sort of skin thing I had as a kid. And its efficacy ought to be easily testable. Being a "known fact" isn't good enough, even though it's likely true.

I'm more than open to changing and to seeking and using new therapies. I want the proof first, however. There are many instances where things I was taught were found to be unneeded, and I dropped them. I also added my own wrinkles to surgical techniques, and passed them to others.

It's a simple proposition: if it works, it should be testable, and deserves use, whether herbal or whatever. If tested and found useless, it ought to be discarded.

I think I recall having gentian violet used on some sort of skin thing I had as a kid. And its efficacy ought to be easily testable. Being a "known fact" isn't good enough, even though it's likely true.

That was just a random example off the top of my head - but... let's see: NIH says that the stuff is quite effective against Candida Albicans in even sub-therapeutic concentrations, is effective as well as very cheap for oropharyngeal candidiasis treatment, etc. In fact, there are over 1600 hits for "gentian violet" in their search engine, and quite a bit of data showing that it is effective, inexpensive, and safe... but I guarantee that you're going to get a Nystatin scrip for anything like the above, despite Nystatin's side effects.

By the same token, C-sections are now the norm in most places in the US, and natural childbirth is prohibited in various places (e.g., North Carolina) - even though the WHO says that a C-section rate of greater that 15% is excessive in a normal population. There's also little or no support or education, in most clinical settings, for breastfeeding mothers - even though that is by far the healthiest alternative for children. So, is standard medical "wisdom" always the right answer? Not so much.

In any case, I agree with you when you say that we're not far apart on these things; I've occasionally told people that an open mind is a fine thing, but having it open so wide that birds can make deposits isn't (OK, so I'm not the most politic fellow in the world at times. :) I think that our rational critical facility - the thing that's brought us cars, rockets, cell phones, etc. - needs to be exercised in all cases, including medicine of whatever sort - and that we need to get quality information on the important issues that affect our lives. Too many people get lazy about that, and have an investment in "easier" paths - i.e., trusting the shamans. I have a problem with that mindset... no matter what side of which fence it's on.

About Me

I'm a mostly retired general surgeon. With my surgical blog, my intention is to inform, entertain, and possibly educate the reader about surgery, and about the life and loves of a surgeon: this one, anyway. Don't know what I'm thinking, doing a political blog, too.
In an amazing coincidence, I've also written a book, "Cutting Remarks; Insights and Recollections of a Surgeon." It's about my surgical training in San Francisco in the 1970s, aimed at the lay reader with the goal of entertaining with good stories, informing with understandable details of surgical anatomy, procedures, and diseases. Knowing you, I bet you'd enjoy it. In fact, if you like Surgeonsblog, you'll absolutely love the book!

Boring, Unoriginal, but Important Disclaimer:

What I say here is as true as I can make it, based on my experience as a surgeon. Still, in no way is it intended as specific medical advice for any condition. For that, you need to consult your own doctors, who actually know you. I hope you'll find things of interest and amusement here; maybe useful information. But please, please, PLEASE understand: this blog ought not be used in any way to provide the reader with ideas about diagnosis or treatment of any symptoms or disease. Also, as you'd expect, when I describe patients, I've changed many personal details: age, sex, occupation -- enough to make them into no one you might actually know. Thanks, and enjoy the blog.